Preeclampsia–Eclampsia

Gupte, Suraj; Wagh, Girija

doi:10.1007/s13224-014-0502-y

Cited by 59 publications

(75 citation statements)

References 13 publications

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“…Data from National Eclampsia Registry published in 2014 showed an incidence of 1.09 % [12]. Table 1 shows the trend of incidence of eclampsia in India over the decades.…”

Section: Results and Observationsmentioning

confidence: 99%

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Eclampsia in India Through the Decades

Nobis¹,

Hajong²

2016

J Obstet Gynecol India

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Background Eclampsia is still prevalent in India with high maternal and perinatal mortality. In India, there is no community-based survey of eclampsia. Sporadic reports of study on eclampsia are being published in medical journals.Objectives The objective of this study was to find out the incidence of eclampsia and maternal and perinatal mortality in India. Methods Data on incidence, maternal mortality and perinatal mortality of eclampsia were collected from articles published in journals and from book of Abstract published during AICOG conferences from 1980 onwards, along with our own data from 1976 to 2014. Data were analyzed yearwise. Results Reports published from 1976 to 2015 (JanuaryFebruary) reveal that incidence of eclampsia in India ranges from 0.179 to 5 %, the average being 1.5 %. In the period between 1980 and 1989, the average incidence was 0.92 % and the corresponding figure between 2002 and 2010 was 2.15 %, indicating that there is no reduction in Dr. P. N. Nobis Retired as Professor and Head of the Department of Obstetrics and Gynecology from Silchar MedicalCollege is now working at International Hospital at Dispur, Guwahati, as Senior Consultant. He has about ten publications in National Journals including six in this journal. He has authored three textbooks of Obstetric and Gynaecology of which one is in vernacular. He has special interest in hypertensive disorders of pregnancy and pediatric gynecology.The Journal of Obstetrics and Gynecology of India (September-October 2016) 66(S1):S172-S176 DOI 10.1007/s13224-015-0807-5123 incidence of eclampsia in India over the decades. Maternal mortality in 1982 was 14.12 %, and in 2010 it was 2.2-9 %. Maternal mortality has shown a receding tendency, while perinatal mortality is remaining still high as in 1984 it was 45 % and the corresponding figure in 2010 was 24.5-48 %. Conclusion Incidence of eclampsia in India is about 1.5 %. Detail analysis of data from 1980 to 2015 (JanuaryFebruary) shows that there is no reduction in incidence of eclampsia and perinatal mortality rate over the last few decades. Maternal mortality has shown a slight receding trend.

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“…Data from National Eclampsia Registry published in 2014 showed an incidence of 1.09 % [12]. Table 1 shows the trend of incidence of eclampsia in India over the decades.…”

Section: Results and Observationsmentioning

confidence: 99%

“…Care below expectation in the primary healthcare establishment is another disturbing factor as evident from report of National Eclampsia Registry that only 44 % of women had eclampsia prevention with magnesium sulfate before admission to hospital [12].…”

Section: Discussionmentioning

confidence: 99%

Eclampsia in India Through the Decades

Nobis¹,

Hajong²

2016

J Obstet Gynecol India

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“…8 This variation seen in the incidence is due to difference in socioeconomic factors, available obstetric care, financial and geographic barriers and cultural practices.…”

Section: -7mentioning

confidence: 99%

“…As per NER data 76.34% of the patients were between 21 and 30 years of age. 8 Gravidity also influences the incidence of eclampsia. In present study majority 78 (62.90 %) of patients were primigravidae.…”

Section: -7mentioning

confidence: 99%

“…Time spent in access to care is crucial and may alter maternal and fetal outcome. 8 96 % of referred patients received injection MgSO4 in referral facilities before referral to our institute. The positive research data from the Magpie trial led institutions including the WHO and the American College of Obstetricians and Gynaecologist (ACOG) to recommend the use of magnesium sulfate as the first-line treatment for preeclampsia and eclampsia.…”

Section: -7mentioning

confidence: 99%

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Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital

Jain

Bindal

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Eclampsia is defined as the development of convulsions and / or unexplained coma during pregnancy or postpartum in patients with signs and symptoms of preeclampsia. The objective of present study was to investigate the incidence of eclampsia, the clinical profile, maternal and perinatal outcomes in eclamptic patients in our hospital setting.Methods: The retrospective analysis of case records of all eclampsia cases was done over a period of one year, in department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India.Results: The incidence of eclampsia was13.04/1000 deliveries. Eclampsia was more common in the age group 20-24 years (55.64%), primigravidae (62.90%) and patients from rural areas (76.61%). Majority (91%) of women were referred from different hospitals. 112 (90.32%) patients were unbooked. 74 (59.67%) patients developed eclampsia during antenatal period before onset of labor. 67.01% patients presented at gestational age > 37 weeks. Lower segment caesarean section was the predominant mode of delivery in 66 (68.04%) patients. 11.29% patients required ventilatory support and pulmonary edema developed in 4.83% of cases. Maternal death occurred in 7.25% of cases.with a case fatality rate of 16.07%. Pulmonary edema was the commonest cause of death. 7 (5.6%) patients presented with intrauterine death on admission. There were 5 (4.06%) perinatal deaths reported in present study.Conclusions: Eclampsia is still a common and serious complication of pregnancy. Proper antenatal care, detection of preeclampsia with early management and timely referral of high - risk patients, administration of MgSO4 in correct doses and properly timed caesarean section in selected cases would reduce the incidence of eclampsia associated maternal and perinatal morbidity and mortality in our facility.

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Eclampsia

Gupte¹

2016

Principles of Critical Care in Obstetrics

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Eclampsia is an acute and severe complication of preeclampsia. In classic eclampsia severe rise in hypertension is followed with acute headache and tonic-clonic convulsions. Eclampsia cases are rarely seen in developed countries (1 in 2000); however, in developing countries, the fi gures are much higher.The FOGSI-ICOG National Eclampsia Registry has brought forth some revealing trends. Eclampsia prevalence among registry patients is 1.9 %. National sample surveys in the past have shown prevalence to be 1-5 %. This is out of the 111,725 deliveries analyzed from the cases reported by 175 reporting centers. The number of cases of eclampsia is more than cases of imminent eclampsia. This points to the lost opportunities of prevention. 17 % of preeclampsia patients are actually in the adolescent age group refl ecting the very early age at marriage in spite of several awareness programs and legal guidelines. 76.34 % of the patients were between 21 and 30 years of age, thus rendering a very young population morbid and at risk of mortality. It also is a disease of the fi rst-time pregnant woman as 81 % of the patients with preeclampsia are primigravid.Antenatal care has been identifi ed as the single intervention which could infl uence the maternal mortality of our country. Many women still seem to be unreached with this basic pregnancy evaluation. Most of the patients reported by the registry were registered for antenatal care either in the second (40.98 %) or the third trimester (46.28 %). Very few (12.54 %) were booked in the fi rst trimester [ 1 ]. Pathophysiology of EclampsiaPathophysiology of eclampsia has remained enigmatic for a long time. This was because clinical and investigative research was diffi cult in such an acute and severe condition. New research has identifi ed two different pathways causing the clinical symptoms of convulsions.Severely raised systemic blood pressure leads to fi rst cerebral vasospasm followed by decreased cerebral perfusion, leading to cerebral anoxia. This leads to ischemic damage and cerebral edema causing eclamptic foci in the brain and convulsion.Raised cerebral perfusion pressure also causes endothelial damage, barotrauma, and vascular damage, leading to cerebral edema, hemorrhage, and cerebral irritability in some cases.But there are some atypical cases where systemic hypertension is not high but still they get eclamptic convulsions. This is depicted to be due to abnormal autoregulation in the cerebral circulation.

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Preeclampsia–Eclampsia

Cited by 59 publications

References 13 publications

Eclampsia in India Through the Decades

Eclampsia in India Through the Decades

Maternal and perinatal outcomes in eclampsia: a retrospective analysis in a referral hospital

Eclampsia

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